Utility of the Nutritional Screening in Predicting Adverse Outcome of Patients With Overweight/Obesity and Acute Heart Failure
Utility of the Nutritional Screening in Predicting Adverse Outcome of Patients With Overweight/Obesity and Acute Heart Failure
复制标题
营养筛查在预测超重/肥胖合并急性心力衰竭患者不良结局中的作用
DOI：
10.1016/j.cardfail.2020.02.005
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发表时间：
2020-07-01
影响因子：
6
通讯作者：
Watarai, Masato
中科院分区：
文献类型：
--
作者：
Uemura, Yusuke;Shibata, Rei;Watarai, Masato
背景：营养不良是心力衰竭（HF）患者不良结局的负性预测因子。尽管HF患者的体重指数（BMI）升高具有生存优势，但BMI并不一定反映良好的营养状况。在本研究中，我们调查了营养筛查对HF和超重/肥胖患者的临床影响。方法：我们检查了170例因急性HF入院的超重或肥胖状态（定义为BMI ≥ 25 kg/m2）患者的数据。入院时计算其控制性营养状况（CONUT）评分。结果：随访中位时间为1096天（四分位距，805-1096天）。66.5%的患者存在营养不良。Kaplan-Meier生存分析表明，营养不良患者的全因死亡和因HF再入院的发生率高于无营养不良的患者。多变量考克斯回归分析显示，CONUT评分，但不是BMI和老年营养风险指数，是独立相关的预后不良。结论：营养不良是非常普遍的，独立预测超重/肥胖和急性HF患者的预后不良。
Background: Undernutrition is a negative predictor of adverse outcomes in patients with heart failure (HF). Despite the survival advantage of elevated body mass index (BMI) in patients with HF, BMI does not necessarily reflect a favorable nutritional status. In the present study, we investigated the clinical impact of nutritional screening in patients with HF and overweight/obesity.Methods: We examined the data from 170 patients with overweight or obesity status (defined as BMI >= 25 kg/m(2)) who admitted for acute HF. Their controlling nutritional status (CONUT) score was calculated on admission. The CONUT score is regarded as an index of the nutritional status.Results: The median duration of follow-up was 1096 days (interquartile range, 805-1096 days). Undernutrition was identified in 66.5% of the patients. Kaplan-Meier survival analysis demonstrated that patients with undernutrition had a higher incidence of all-cause death and readmission due to HF than those without undernutrition. Multivariate Cox regression analysis revealed that the CONUT score, but not BMI and the geriatric nutritional risk index, was independently correlated with poor prognosis.Conclusions: Undernutrition is highly prevalent and independently predicts poor outcomes in patients with overweight/obesity and acute HF.